Mental health emergencies: UK and Australia rethink police response

When police become first responders: the mental health crisis in emergency calls

For years, the default response to a mental health emergency in the UK and Australia has been the same: dial 999 or 000, and police arrive. But a growing body of evidence—fuelled by inquests into deaths in custody and public outrage—is forcing governments to reconsider who should answer these calls. This week, New South Wales became the first Australian state to trial a system where mental health professionals, not officers, assess emergency calls. The UK, where similar debates have simmered for a decade, is watching closely.

The shift is not just procedural. It reflects a fundamental question: when someone is in psychological distress, is a uniformed officer with a baton and handcuffs the right person to help? In Australia, the answer is increasingly no. In the UK, where at least 1,800 people have died in or following police custody since 1990—with mental health a recurring factor—the question is urgent, if not yet resolved.

Australia’s experiment: nurses over handcuffs

New South Wales’ reform, announced on Thursday, will embed mental health clinicians in emergency call centres to triage 000 calls. If the situation is deemed non-violent, paramedics or mental health teams will be dispatched instead of police. The change follows a string of high-profile deaths, including that of 95-year-old Clare Nowland, who was tasered by police during a mental health episode in a nursing home last year.

The move is partial—it won’t apply 24/7 statewide—and critics argue it doesn’t go far enough. But it marks a rare acknowledgment from government that police are ill-equipped to handle mental health crises. "This is about ensuring people get the right response at the right time," said Mental Health Minister Rose Jackson. The state’s police commissioner, Karen Webb, has also backed the change, a notable shift from an institution often resistant to ceding control.

The UK has no equivalent system, though pilot schemes in cities like London and Birmingham have tested co-response models, where police and mental health professionals attend calls together. These have shown promise—one London trial reduced police time spent on mental health calls by 40%—but have yet to be scaled nationally. The difference in Australia is political will: the NSW government is framing the reform as a public health issue, not a policing one.

The UK’s reckoning: deaths, delays, and a system under strain

In Britain, the debate over police involvement in mental health emergencies has been reignited by a series of inquests into deaths in custody. In 2022, 23-year-old Chris Kaba was shot dead by police in London after officers mistook his car for a vehicle linked to a firearms incident. Kaba, who was unarmed, had no history of violence but was experiencing a mental health crisis. The case, still under investigation, has become a flashpoint for calls to demilitarise mental health responses.

The UK’s current system relies on Section 136 of the Mental Health Act, which allows police to detain someone they believe is a risk to themselves or others. But critics argue this powers is overused. Data from the Independent Office for Police Conduct (IOPC) shows that in 2022-23, police in England and Wales used Section 136 more than 30,000 times—up 15% in five years. Black people are four times more likely to be detained under the act than white people, a disparity that has fuelled accusations of institutional racism.

The alternative—mental health ambulances or crisis teams—exists in pockets. The NHS’s "street triage" teams, launched in 2014, pair police with mental health nurses, but coverage is patchy. In some areas, like Devon, the service has been cut due to funding pressures. Elsewhere, waits for mental health ambulances can stretch to 12 hours, leaving police as the default option by necessity, not design.

What’s at stake: trust, safety, and the limits of reform

The push to remove police from mental health emergencies is not just about reducing harm—it’s about rebuilding trust. In communities where police are viewed with suspicion, particularly among Black and minority ethnic groups, the sight of officers responding to a crisis can escalate tensions. "For many people, police presence is itself a trigger," said Marcia Rigg, whose brother Sean died in police custody in 2008 after being restrained. "We need a system that doesn’t criminalise distress."

But reform is fraught with challenges. Mental health services in both countries are chronically underfunded. In the UK, the Care Quality Commission has warned that NHS mental health trusts are "stretched to breaking point," with bed shortages forcing patients to travel hundreds of miles for treatment. In Australia, a 2023 royal commission found that the mental health system was "broken," with waiting times for community care often exceeding a year.

There’s also the question of cost. NSW’s new triage system will require hiring hundreds of mental health professionals, a significant investment at a time when state budgets are under pressure. In the UK, the government has pledged £150 million to expand mental health crisis teams, but critics say this is a fraction of what’s needed.

The global context: a shift away from policing

The moves in Australia and the UK reflect a broader international trend. In the US, cities like Denver and Portland have pioneered "behavioural health response" teams, which have reduced police involvement in mental health calls by up to 80%. In Canada, a 2022 report by the Ontario Human Rights Commission called for police to be removed from mental health responses entirely, citing "systemic racism" in policing.

But progress is uneven. In some US states, police budgets have been redirected to mental health services—only to be clawed back after political backlash. In the UK, the government’s 2022 white paper on mental health reform proposed expanding crisis teams but stopped short of mandating their use.

For now, the question remains: can these reforms be scaled before the next tragedy? In Australia, the answer may hinge on whether the NSW trial can prove that mental health professionals are not just better equipped than police—but that the system can afford them. In the UK, the challenge is more fundamental: convincing a government that mental health is a public health issue, not a policing one.

What’s clear is that the status quo is no longer tenable. Every year, people in crisis are met with handcuffs when they need help. The question is not whether the system should change, but how quickly—and at what cost.